Endometrium procurement and transplantation restores fertility in rats.

RESEARCH QUESTION: Can rat endometrium be successfully procured and transplanted, and can a similar method be used to procure human endometrium? DESIGN: Rat endometrium was procured using an endometrium stripping method and transplanted into female Sprague-Dawley rats. Macroscopic and histological changes, endometrial receptivity-related protein concentrations and fertility were assessed. Additionally, a preliminary experiment was conducted to procure human endometrium using a similar method. RESULTS: Endometrium was successfully procured from both rats and humans, which contained intact endometrium and parts of the adjacent inner annulus myometrium. Endometrium auto-transplantation was conducted in rats and the procedure lasted a total of 41.3 ± 5.7 min with a mean blood loss of 0.09 ± 0.04 g. The transplanted endometrium survived well, but a fibrotic zone formed between the transplant and recipient tissue. Compared with sham rats, those with endometrium transplantation had similar endometrial thickness and endometrial gland numbers but reduced vascular density at 8 weeks after surgery. Endometrium transplantation also retained expression of the endometrial receptivity-related proteins leukaemia inhibitory factor and vascular endothelial growth factor. In contrast to non-pregnancy in the stripped horn, a mean of 5.0 ± 2.7 fetuses developed in the transplanted horn, and full-term live fetuses were conceived in the horns with transplanted endometrium. CONCLUSIONS: Endometrium procurement by stripping method can obtain an intact and functional endometrium, and endometrium transplantation can reconstruct the uterine cavity and restore fertility in rats.

Double Asymmetric Core Optimizes Crystal Packing to Enable Selenophene-based Acceptor with Over 18 % Efficiency in Binary Organic Solar Cells.

Side-chain tailoring is a promising method to optimize the performance of organic solar cells (OSCs). However, asymmetric alkyl chain-based small molecular acceptors (SMAs) are still difficult to afford. Herein, we adopted a novel asymmetric n-nonyl/undecyl substitution strategy and synthesized two A-D1 A'D2 -A double asymmetric isomeric SMAs with asymmetric selenophene-based central core for OSCs. Crystallographic analysis indicates that AYT9Se11-Cl forms a more compact and order intermolecular packing compared to AYT11Se9-Cl, which contributed to higher electron mobility in neat AYT9Se11-Cl film. Moreover, the PM6 : AYT9Se11-Cl blend film shows a better morphology with appropriate phase separation and distinct face-on orientation than PM6 : AYT11Se9-Cl. The OSCs with PM6 : AYT9Se11-Cl obtain a superior PCE of 18.12 % compared to PM6 : AYT11Se9-Cl (17.52 %), which is the best efficiency for the selenium-incorporated SMAs in binary BHJ OSCs. Our findings elucidate that the promising double asymmetric strategy with isomeric alkyl chains precisely modulates the crystal packing and enhances the photovoltaic efficiency of selenophene-incorporated SMAs.

Mutational landscape of nasopharyngeal carcinoma based on targeted next-generation sequencing: implications for predicting clinical outcomes.

BACKGROUND: The aim of this study was to draw a comprehensive mutational landscape of nasopharyngeal carcinoma (NPC) tumors and identify the prognostic factors for distant metastasis-free survival (DMFS). METHODS: A total of forty primary nonkeratinizing NPC patients underwent targeted next-generation sequencing of 450 cancer-relevant genes. Analysis of these sequencing and clinical data was performed comprehensively. Univariate Cox regression analysis and multivariate Lasso-Cox regression analyses were performed to identify factors that predict distant metastasis and construct a risk score model, and seventy percent of patients were randomly selected from among the samples as a validation cohort. A receiver operating characteristic (ROC) curve and Harrell's concordance index (C-index) were used to investigate whether the risk score was superior to the TNM stage in predicting the survival of patients. The survival of patients was determined by Kaplan-Meier curves and log-rank tests. RESULTS: The twenty most frequently mutated genes were identified, such as KMT2D, CYLD, and TP53 et al. Their mutation frequencies of them were compared with those of the COSMIC database and cBioPortal database. N stage, tumor mutational burden (TMB), PIK3CA, and SF3B1 were identified as predictors to build the risk score model. The risk score model showed a higher AUC and C-index than the TNM stage model, regardless of the training cohort or validation cohort. Moreover, this study found that patients with tumors harboring PI3K/AKT or RAS pathway mutations have worse DMFS than their wild-type counterparts. CONCLUSIONS: In this study, we drew a mutational landscape of NPC tumors and established a novel four predictor-based prognostic model, which had much better predictive capacity than TNM stage.

Possible atmospheric source of NH2SO3H: the hydrolysis of HNSO2 in the presence of neutral, basic, and acidic catalysts.

NH2SO3H can directly participate in H2SO4-(CH3)2NH-based cluster formation, and thereby substantially enhance the cluster formation rate. Herein, the reaction mechanisms and kinetics for the formation of NH2SO3H from the hydrolysis of HNSO2 without and with neutral (H2O, (H2O)2, and (H2O)3), basic (NH3 and CH3NH2), and acidic (HCOOH, H2SO4, H2SO4⋯H2O, and (H2SO4)2) catalysts were studied theoretically at the CCSD(T)-F12/cc-pVDZ-F12//M06-2X/6-311+G(2df,2pd) level. The calculated results showed that neutral, basic, and acidic catalysts decrease the energy barrier by over 18.1 kcal mol-1; meanwhile, the product formation of NH2SO3H was more strongly bonded to neutral, basic, and acidic catalysts than to the reactants HNSO2 and H2O. This reveals that the reported neutral, basic, and acidic catalysts promote the formation of NH2SO3H from the hydrolysis of HNSO2 both kinetically and thermodynamically. Kinetic calculations using the master equation showed that (H2O)2 (100% RH) dominate over the other catalysts within the range of 0-10 km altitudes and 230-320 K with its rate ratio larger by at least 2.98 times, whereas HCOOH (3.2 × 109 molecules cm-3) is the most favorable catalysts at 15 km altitude in the troposphere. Overall, the present results will provide a definitive example that neutral, basic, and acidic catalysts have important influences on atmospheric reactions.

Saccharomyces cerevisiae improves rennet-induced gelation of ultra-high temperature milk.

Heating milk at high temperatures impairs its renneting properties, but rennet-induced curds can be formed from ultra-high temperature (UHT) milk inoculated with Saccharomyces cerevisiae. Herein, we measured physicochemical indices of UHT milk inoculated with S. cerevisiae before rennet addition, monitored the kinetics of gel formation, and investigated the physicochemical properties and microstructure of rennet-induced curds to explore the mechanisms by which S. cerevisiae influenced rennet-induced gelation of UHT milk. Compared with untreated pasteurized cow milk and UHT milk, the ethanol content was increased, the pH was decreased, the particle size and ζ-potential were increased, the time points at which the elasticity index began to increase were advanced, and the maximum elasticity index was increased for UHT milk inoculated with S. cerevisiae. The number of S. cerevisiae cells affected the structure of rennet-induced curds; with few cells added, the protein network of curds was continuous and tight, the mean square displacement curves showed an asymptotic behavior, and the water retention capacity and curd yield were high; with more cells added, the loosely entangled proteins aggregated, the continuity of the network was destroyed, and the curd yield decreased. In summary, a low number of S. cerevisiae cells (<1.0 × 107 cfu/mL) can increase particle size, ζ-potential, and ethanol content, and decrease pH of S. cerevisiae-inoculated UHT milk, thereby accelerating the aggregation reactions after enzymatic reaction and improving the renneting properties.

Determination of protein kinase A activity and inhibition by using hydroxyapatite nanoparticles as a fluorescent probe.

The authors describe a fluorometric method for the determination of the activity and inhibition of protein kinase A (PKA). In the presence of ATP, PKA catalyzes the transfer of phosphate groups from ATP to a peptide, and the generated phosphorylated peptide quenches the fluorescence (measured at excitation/emission peaks of 340/440 nm) of the hydroxyapatite nanoparticles (HAP-NPs). A linear logarithmic relationship of PKA concentrations with fluorescence intensity in the range from 1 to 50 U·L-1 was obtained, and the lower limit of detection (LOD) is 0.5 U·L-1. This is much lower than LODs reported in the literature. The PKA inhibitor H-89 was studied, and the inhibition plot has a sigmoidal shape with a half-maximal inhibitory concentration of around 750 nM of H-89. At a 4.5 nM level of H-89, fluorescence of HAP-NPs fell to levels of no PKA controls, demonstrating that the assay is a viable tool to screen for kinase inhibitors. An assay with Hela cell lysates in combination with forskolin (an activator of adenylyl cyclase) and IBMX (a phosphodiesterase inhibitor used to activate the cellular activity of PKA) resulted in decreased fluorescence of HAP-NPs. This suggests that the assay can be applied for testing in vitro cell kinase activity. In our perception, this method will enable high-throughput screening for kinase-related drugs and fluorometric enzymatic detection in various areas. Graphical abstract Fluorescence assay based on hydroxyapatite nanoparticles (HAP) fluorescence quenching was developed for analysis of the activity and inhibition of protein kinase A (PKA).

Study of the development patterns of water-conducting fracture zones under karst aquifers and the mechanism of water inrush.

The hydrogeological conditions of the Qianbei coalfield are complex, and karst water in the roof rock frequently disrupts mining operations, leading to frequent water inrush incidents. Taking the representative Longfeng Coal Mine as a case study, research was conducted on the development pattern of the water-conducting fracture zone and the water inrush mechanisms beneath karst aquifers. On the basis of key stratum theory and calculations of the stratum stretching rate, the karst aquifer in the Changxing Formation was identified as the primary key stratum. It was deduced that the water-conducting fracture zone would develop into the karst aquifer, indicating a risk of roof water inrush at the working face. Numerical simulations were used to study the stress field, displacement field, and plastic zone distribution patterns in the overlying roof strata. Combined with similar simulation tests and digital speckle experiments, the spatiotemporal evolution characteristics of the water-conducting fracture zone were investigated. During the coal mining process, the water-conducting fracture zone will exhibit a "step-type" development characteristic, with the fracture morphology evolving from vertical to horizontal. Near the goaf boundary, the strain gradually decreases, and the instability of the primary key stratum significantly impacts the mining space below, leading to the closure of interlayer voids or the redistribution of water-conducting fissure patterns. Field measurements of the water-conducting fracture zone reveal that postmining roof fractures can be classified into tensile-shear, throughgoing, and discrete types, with decreasing water-conducting capacity in that order, the measured development height of the water-conducting fracture zone (51 m) aligns closely with the theoretical height (51.37 m) and the numerical simulation height (49.17 m). Finally, from the perspective of key stratum instability, the disaster mechanisms of dynamic water inrush and hydrostatic pressure water inrush beneath the karst aquifers in the northern Guizhou coalfield were revealed. The findings provide valuable insights for water prevention and control efforts in the Qianbei coalfield mining area.

CsMOF1-guided regulation of drought-induced theanine biosynthesis in Camellia sinensis.

The distinctive flavor and numerous health benefits of tea are attributed to the presence of theanine, a special amino acid found in tea plants. Nitrogen metabolite is greatly impacted by drought; however, the molecular mechanism underlying the synthesis of theanine in drought-stricken tea plants is still not clear. Through the drought transcriptome data of tea plants, we have identified a gene CsMOF1 that appears to play a role in theanine biosynthesis under drought stress, presenting a significantly negative correlation with both theanine content and the expression of CsGS1. Further found that CsMOF1 is a transcription factor containing a MYB binding domain, localized in the nucleus. Upon silencing CsMOF1, there was a prominent increase in the level of the theanine and glutamine, as well as the expression of CsGS1, while glutamic acid content decreased significantly. Conversely, overexpression of CsMOF1 yielded opposite effects. Dual luciferase reporter assay and electromobility shift assays demonstrated that CsMOF1 binds to the promoter of CsGS1, thereby inhibiting its activity. These results indicate that CsMOF1 plays a crucial role in theanine biosynthesis in tea plants under drought stress, acting as a transcriptional repressor related to theanine biosynthesis. This study provides new insights into the tissue-specific regulation of theanine biosynthesis and aids with the cultivation of new varieties of tea plants.

Research on an identification model for mine water inrush sources based on the HBA-CatBoost algorithm.

Accurate and efficient identification of water inrush sources, as one of the three critical elements of mine water hazards, is crucial for mine water management. To identify the sources of mine water inrush effectively, a model named HBA-CatBoost is introduced. This model is established on the hybrid bat algorithm (HBA)-optimized category feature gradient boosting tree (CatBoost), and the shapley additive explanation (SHAP) method is employed to elucidate the model's decision-making process. Given the prevalent occurrence of water hazards in coal seam roofs and floors in the northern Guizhou coalfield, coupled with the challenges in pinpointing water inrush sources in mines, the HBA-CatBoost model is tested at the Longfeng Coal Mine in northern Guizhou to validate its practicality. Comparative analysis with the HBA-RF, HBA-XGBoost, CatBoost, RF, and XGBoost models demonstrates that the hybrid bat algorithm significantly enhances the classification performance of the CatBoost model, resulting in improved convergence speed and classification accuracy. The HBA-CatBoost model outperforms the aforementioned models in terms of classification effectiveness, achieving accuracy, recall, precision, and F1 scores of 96.43%, 97.22%, 96.43%, and 96.61%, respectively. The SHAP method elucidates the decision mechanism of the optimal HBA-CatBoost model, highlighting the significance of sample features and bolstering the model's credibility. These outcomes underscore the superior performance of the HBA-CatBoost model and its potential for effectively identifying water inrush sources in mines.

The role of CD24hiCD27+ regulatory B cells in human chronic rhinosinusitis with/without nasal polyps.

BACKGROUND: Regulatory B cells (Bregs) reduce allergic and autoimmune inflammation. However, their role in chronic rhinosinusitis (CRS) remains unknown. This study investigated the frequency and function of Breg subsets in the peripheral blood of patients with CRS. METHODS: The demographic and clinical characteristics were compared among control, CRSsNP, neCRSwNP, and eCRSwNP groups. The expression of various Breg subtypes was evaluated in peripheral blood mononuclear cells (PBMCs) of patients with eosinophilic CRS with nasal polyps (eCRSwNP), non-eosinophilic CRS with nasal polyps (neCRSwNP), CRS without nasal polyps (CRSsNP). CD19+CD24hiCD27+ B cells (B10 cells) were isolated by flow cytometry, followed by RNA sequencing (RNA-seq). Finally, IL-10 secreted by B10 cells were evaluated through the intracellular stain. RESULTS: A higher number of eosinophils in peripheral blood and nasal polyps were found in eCRSwNP compared with neCRSwNP, CRSsNP, and control groups. The frequency of B10 in the peripheral blood B cells (B10%) of patients with eCRSwNP was significantly lower than that in the neCRSwNP and control groups. B10% was negatively correlated with the quantity of tissue eosinophils, and the percentage and absolute value of peripheral blood eosinophils. The eCRSwNP, neCRSwNP and control groups had 1403 differentially expressed genes, 35 of which were identified in four highly enriched pathways. Additionally, the frequency of IL-10+B10 cells in peripheral blood was lower in patients with eCRSwNP than in the neCRSwNP and control groups. CONCLUSION: This study is the first to reveal differences in both the quantity and IL-10 secretion of B10 cells in patients with eCRSwNP and neCRSwNP. These variations were strongly negatively associated with eosinophils in nasal polyps and peripheral blood. IL-10+B10 cells may play a key role in the pathological mechanisms of CRS, particularly the recurrence of eCRSwNP.

Mechanical effect of different patterns for preparation of orthodontic appliances: An experimental study.

Archwire bending is the key to orthodontic treatment, and multi-time bendings are inevitable during manual and robotic automated bending. The purpose of this paper is to quantitatively evaluate the mechanical effects of the different preparation modes and to compare the mechanical properties of the orthodontic loops in one and multiple bends. Three types of typical stainless steel orthodontic loops (vertical loop, T-loop, and L-loop) were used to quantify the mechanical effect of patterns for preparation by experimental comparison between loops with different bending times by using an orthodontic force tester (OFT). The results were statistically analyzed by t-test. The fracture test of the stainless steel archwire was also carried out, and the bending times at fracture were recorded. Results of the tests indicate that one-time and multi-time bending have a significant mechanical effect on orthodontic appliances. Multi-time bending causes significant mechanical decreases and can damage the appliances.

An integrated strategy for nutrient harvesting from hydrolyzed human urine as high-purity products: Tracking of precipitation transformation and precise regulation.

The nutrient recovery from source-separated urine is of great significance for a sustainable and closed nutrient loop. However, common urine-processing techniques have several constraints, including inefficient recovery, low product purity and incapability of simultaneously harvesting multiple nutrients. In this study, an integrated strategy of P precipitation and N stripping was first proposed to harvest nutrients from hydrolyzed human urine as high-purity products via precisely regulating Ca/P dosing ratio. Ca(OH)2 was utilized to trigger Ca-P precipitation and elevate pH level. Different from the previously reported conventional struvite method, P recovery was oriented to calcium phosphate. P harvesting behavior was investigated as a function of key factors including initial P concentration and the dosing ratio. A thermodynamic model was constructed to unveil the precipitation transformation mechanism and visualize P recovery for an enhanced controllability. For N harvesting, Ca(OH)2 was dosed to increase the pH of the urine to converts ammonium to ammonia. The resulting ammonia was stripped and then adsorbed by H2SO4 as high-purity ammonium sulfate. Moreover, the sulfate derived from acidification treatment was recovered as calcium sulfate in the interests of material recycling and mitigating secondary contaminations. Results exhibited P recovery efficiency could reach 100 % and purity for calcium phosphate could be above 90 % within a Ca/P ratio range of 1.67-2.0. Further boosting pH to 12, over 85 % of S and 95 % of N was retrieved. The comprehensive scheme provides an efficient approach towards the precise P and N harvesting from hydrolyzed urine and advances the knowledge of precipitation transformation mechanism.

A Survey of Conversational Agents and Their Applications for Self-Management of Chronic Conditions.

Conversational agents have gained their ground in our daily life and various domains including healthcare. Chronic condition self-management is one of the promising healthcare areas in which conversational agents demonstrate significant potential to contribute to alleviating healthcare burdens from chronic conditions. This survey paper introduces and outlines types of conversational agents, their generic architecture and workflow, the implemented technologies, and their application to chronic condition self-management.

Genome-Wide Investigation and Functional Analysis Reveal That CsKCS3 and CsKCS18 Are Required for Tea Cuticle Wax Formation.

Cuticular wax is a complex mixture of very long-chain fatty acids (VLCFAs) and their derivatives that constitute a natural barrier against biotic and abiotic stresses on the aerial surface of terrestrial plants. In tea plants, leaf cuticular wax also contributes to the unique flavor and quality of tea products. However, the mechanism of wax formation in tea cuticles is still unclear. The cuticular wax content of 108 germplasms (Niaowang species) was investigated in this study. The transcriptome analysis of germplasms with high, medium, and low cuticular wax content revealed that the expression levels of CsKCS3 and CsKCS18 were strongly associated with the high content of cuticular wax in leaves. Hence, silencing CsKCS3 and CsKCS18 using virus-induced gene silencing (VIGS) inhibited the synthesis of cuticular wax and caffeine in tea leaves, indicating that expression of these genes is necessary for the synthesis of cuticular wax in tea leaves. The findings contribute to a better understanding of the molecular mechanism of cuticular wax formation in tea leaves. The study also revealed new candidate target genes for further improving tea quality and flavor and cultivating high-stress-resistant tea germplasms.

Phosphorus harvesting from fresh human urine: A strategy of precisely recovering high-purity calcium phosphate and insights into the precipitation conversion mechanism.

Phosphorus (P) harvesting from source-separated urine to optimize the overall nutrient loop is one of the most appealing benefits and is a global research interest in wastewater management and treatment. However, current P precipitation is mainly oriented to struvite, which is limited by the issues such as relatively low product purity and high cost of Mg source. Distinguished from previous conventional struvite precipitation, the strategy of precisely harvesting P from fresh human urine as high-purity calcium phosphate was first proposed in this study. This enhanced strategy can optimize P harvesting performance and product purity by simply regulating the consumption of calcium-based materials via model simulation and experimental validation. The thermodynamic model was constructed to probe the precipitation conversion mechanism, and visually predict the component and yield for products under various operating conditions. Batch experiments were conducted to investigate P recovery performance as a function of initial Mg2+ concentration, initial pH level, as well as degree of urine hydrolysis. Moreover, the alternative dosing scheme with different calcium salts and alkali was presented, diversifying the options for efficient P recovery. The results showed that, from the perspective of acidic storage for fresh urine, P recovery can be boosted along with eliminating urine hydrolysis. In urine with an initial pH=2.0, P can be completely recovered and purity for calcium phosphate can be optimized to 100% within a Ca/P ratio range of 1.67-2.3. Overall, this work is of great significance for precisely and efficiently harvesting P from urine and provides an integrated strategy for P resource recovery from urine.

Towards Developing a Voice-activated Self-monitoring Application (VoiS) for Adults with Diabetes and Hypertension.

The integration of motivational strategies and self-management theory with mHealth tools is a promising approach to changing the behavior of patients with chronic disease. In this manuscript, we describe the development and current architecture of a prototype voice-activated self-monitoring application (VoiS) which is based on these theories. Unlike prior mHealth applications which require textual input, VoiS app relies on the more convenient and adaptable approach of asking users to verbally input markers of diabetes and hypertension control through a smart speaker. The VoiS app can provide real-time feedback based on these markers; thus, it has the potential to serve as a remote, regular, source of feedback to support behavior change. To enhance the usability and acceptability of the VoiS application, we will ask a diverse group of patients to use it in real-world settings and provide feedback on their experience. We will use this feedback to optimize tool performance, so that it can provide patients with an improved understanding of their chronic conditions. The VoiS app can also facilitate remote sharing of chronic disease control with healthcare providers, which can improve clinical efficacy and reduce the urgency and frequency of clinical care encounters. Because the VoiS app will be configured for use with multiple platforms, it will be more robust than existing systems with respect to user accessibility and acceptability.

The Basic Helix-Loop-Helix Transcription Factor SmbHLH1 Represses Anthocyanin Biosynthesis in Eggplant.

Many basic helix-loop-helix transcription factors (TFs) have been reported to promote anthocyanin biosynthesis in numerous plant species, but little is known about bHLH TFs that inhibit anthocyanin accumulation. In this study, SmbHLH1 from Solanum melongena was identified as a negative regulator of anthocyanin biosynthesis. However, SmbHLH1 showed high identity with SmTT8, which acts as a SmMYB113-dependent positive regulator of anthocyanin-biosynthesis in plants. Overexpression of SmbHLH1 in eggplant caused a dramatic decrease in anthocyanin accumulation. Only the amino acid sequences at the N and C termini of SmbHLH1 differed from the SmTT8 sequence. Expression analysis revealed that the expression pattern of SmbHLH1 was opposite to that of anthocyanin accumulation. Yeast two-hybrid (Y2H) and bimolecular fluorescence complementation (BiFC) assays showed that SmbHLH1 could not interact with SmMYB113. Dual-luciferase assay demonstrated that SmbHLH1 directly repressed the expression of SmDFR and SmANS. Our results demonstrate that the biological function of bHLHs in anthocyanin biosynthesis may have evolved and provide new insight into the molecular functions of orthologous genes from different plant species.

Remarkable phosphate recovery from wastewater by a novel Ca/Fe composite: Synergistic effects of crystal structure and abundant oxygen-vacancies.

Calcium-based materials are considered to be promising adsorbents for phosphate removal in the water environment due to their environmental friendliness and low price. However, improving the efficiency and rate of P adsorption of calcium-based materials still needs further exploration. In this study, a high-efficiency and eco-friendly Ca/Fe composite was rationally designed and fabricated by a co-precipitated method. Batch adsorption experiments showed that Ca/Fe composites with a Ca: Fe molar ratio of 3: 1 exhibited a remarkable phosphate sorption capacity of 161.4 mg P/g. Furthermore, the phosphate adsorption capacity of Ca/Fe-3/1 composite was maintained relatively high at pH 3-11 due to the ligand exchange, electrostatic and chemical precipitation. In addition, the experiment performed to determine the effect of coexisting ions shows that only carbonate ions slightly inhibit the phosphate adsorption effect of the Ca/Fe-3/1 composite. The newly prepared Ca/Fe composites have a fast phosphate removal efficiency. The XPS and EPR analysis showed that a large number of oxygen vacancies were formed on Ca/Fe composites due to the introduction of magnetic Fe. This is the first time to introduction oxygen vacancies into Ca/Fe composites by co-precipitation. The existence of oxygen vacancies can promote electron transfer rate and reduce the bonding energy barrier for phosphate adsorption, thereby increasing the phosphate absorption rate of the Ca/Fe composites. The enhanced phosphate removal by Ca/Fe composites with abundant oxygen vacancies provides a new strategy for the preparation of commercial phosphate -controlling materials.

[Comparison of overlap ratios of the target volume in different respiratory states with active breathing control for external-beam partial breast irradiation].

OBJECTIVE: To explore the overlap ratio of the target volume in different respiratory statuses of active breath control (ABC) and their differences during external-beam partial breast irradiation (EB-PBI), and from the perspective of target volume overlap to determine the influence of the ABC-assisted breathing condition on intra-fractional target movement of EB-PBI. METHODS: The patients, who received breast-conserving surgery with silver clips marked at the margins of the cavity and were suitable for EB-PBI, were immobilized on the breast bracket to undertake CT simulation assisted by ABC device, six sets of CT simulation images including two sets of image in state of moderate deep inspiration breathing control (mDIBH), two sets of images in state of free breath (FB) and two sets of images in state of deep expiration breathing control (DEBH) were obtained. The six sets of images were transferred to Pinnacle(3) treatment planning system (TPS), then automatic fusion and registration between two sets of mDIBH images, two sets of FB images, two sets of DEBH images and mDIBH image and DEBH image were achieved separately. Thereafter, the overlap ratios of GTV with GTV, CTV with CTV, PTV with PTV were calculated by the Pinnacle(3) TPS. The differences between the overlap ratios of the three kinds of targets in the same registered image and the difference between the overlap ratios of the same kind of target in the different registered images were statistically analyzed using statistical package of SPSS 11.5. RESULTS: Based on mDIBH/mDIBH registration, the overlap ratios of GTV/GTV, CTV/CTV and PTV/PTV were (83.54 ± 11.41)%, (93.00 ± 6.49)%, and (95.26 ± 4.90)%, respectively, and the differences of the overlap ratios between GTV/GTV and CTV/CTV, GTV/GTV and PTV/PTV were all statistically significant (P < 0.05), but statistically not significant between CTV/CTV and PTV/PTV (P > 0.05). Based on FB/FB registration, the overlap ratios of GTV/GTV, CTV/CTV and PTV/PTV were (72.55 ± 29.10)%, (89.36 ± 9.53)% and (92.47 ± 7.25)%, respectively, and the differences of the overlap ratios between GTV/GTV and CTV/CTV, CTV/CTV and PTV/PTV were all not statistically significant (P > 0.05), but statistically significant between GTV/GTV and PTV/PTV (P < 0.05). Based on DEBH/DEBH registration, the overlap ratios of GTV/GTV, CTV/CTV and PTV/PTV were (79.48 ± 22.31)%, (92.83 ± 6.77)% and (95.05 ± 4.81)%, respectively, and the differences of the overlap ratios between GTV/GTV and CTV/CTV (P = 0.000), CTV/CTV and PTV/PTV (P = 0.037), GTV/GTV and PTV/PTV (P = 0.000) were statistically all significant (P = 0.000). The differences of the overlap ratios of GTV/GTV, CTV/CTV, and PTV/PTV (P = 0.000) between mDIBH/mDIBH and DEBH/DEBH, mDIBH/mDIBH and FB/FB, FB/FB and DEBH/DEBH were all statistically significant (P = 0.000), and not statistically significant between mDIBH/mDIBH and mDIBH/DEBH, FB/FB and mDIBH/DEBH. CONCLUSIONS: During the delivering of EB-PBI assisted by ABC, the intra-fractional overlap ratios of the target volume between the same breathing state is increasing in the order of GTV/GTV → CTV/CTV → PTV/PTV. The difference of the overlap ratios of the target volumes between mDIBH and mDIBH, FB and FB, DEBH and DEBH is not significant, and the overlap ratios of PTV/PTV in the three breathing statuses of mDIBH, FB and DEBH reaches a higher level. Therefore, from the perspective of target volume overlap, if the setup error is corrected online before delivering, the necessity of breathing control during delivering of EB-PBI is worthy discussing.